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Purpose: Chronic pelvic pain (CPP) is a relatively common health problem, impacting around 25 million women globally. This study details the development of a multidisciplinary women's CPP clinic at a major U.S. academic medical center, and examines associations between mood, pain symptoms, and trauma history. Materials and Methods: Data were collected from 96 subjects, including self-report measures (Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, and Brief Trauma Questionnaire), pain intensity ratings, psychiatric diagnoses, and relevant medical history. Results: Most subjects reported at least one traumatic experience. Nearly half of subjects met criteria for an anxiety disorder and/or a depressive disorder. Most subjects were diagnosed with pelvic floor dysfunction, and more than half were referred to physical therapy. Women with abdominal/pelvic surgery history reported more traumatic experiences than women without surgical history. Women with a history of sexual abuse reported trying more medications and seeking care from a greater number of providers. Many reported pain duration of >2 years. Conclusions: Study findings related to mental health and trauma support a multidisciplinary CPP approach that includes a clinical health psychology component. Future research may investigate the therapeutic processes that apply to this population to identify targeted efficacious interventions. [ABSTRACT FROM AUTHOR]

Background: Choline is an essential nutrient for brain growth and other processes in the developing neonate. The impact of a maternal plant-based diet on the choline composition of breast milk is unknown.Objective: We assessed the water-soluble choline content of milk from lactating women in the United States following 3 dietary patterns: vegan, vegetarian, and nonvegetarian.Methods: We conducted a cross-sectional study of 74 healthy lactating women who provided a single breast-milk sample using a standardized collection protocol. Participants completed a food-frequency screener and were classified as follows: nonvegetarians (NONVEG) consumed meat; vegetarians (VEGT) consumed milk, dairy, and/or fish; and vegans (VEGAN) consumed animal products less than monthly. Primary outcomes measured were the concentration (in milligrams per liter) and distribution (percentage) of choline from the following water-soluble forms: free choline, phosphocholine (PCho), and glycerophosphocholine (GPC). Differences between diet groups were evaluated with ANOVA.Results: There was a wide range in breast-milk total water-soluble choline (4-301 mg/L), with no significant difference (P > 0.05) by maternal diet pattern. There were differences in choline forms, with VEGAN having a greater mean ± SD concentration and distribution of choline derived from GPC (62.7 ± 25.3 mg/L) than VEGT (47.7 ± 21.2 mg/L) and NONVEG (42.4 ± 14.9 mg/L) (P = 0.0052). There was a lower mean ± SD percentage of choline from PCho (P = 0.0106) in VEGAN (32.5% ± 18.3%) than in VEGT (46.1% ± 18.3%) and NONVEG (44.8% ± 15.7%). Lactation stage and maternal BMI were significantly associated with some choline forms.Conclusions: There was a wide range of water-soluble choline concentrations in the milk of healthy lactating women following vegan, vegetarian, and nonvegetarian diets, with no observed difference in total water-soluble choline concentration by maternal diet. This suggests that maternal plant-based diet by itself is not a risk factor for low breast-milk choline. [ABSTRACT FROM AUTHOR]

Purpose: Essential fatty acids are critical for brain growth and neurodevelopment in infancy. Maternal diet and supplement use have a significant impact on the fat composition of human milk. The objective of this study is to assess supplement utilization patterns and fatty acid and brain-derived neurotrophic factor (BDNF) concentrations in the breast milk of women following vegan, vegetarian, and omnivore diet patterns. Methods: This is a cross-sectional, observational study of 74 lactating women in the United States following a vegan (n = 26), vegetarian (n = 22), or omnivore (n = 26) diet pattern. A single breast milk sample was collected from each participant and assessed for fatty acids and BDNF. Results: Median unsaturated fatty acids in the breast milk of vegan, vegetarian, and omnivores, as a percentage of total fatty acids, was 66.0, 57.8, and 56.2%, respectively (p < 0.001). Total omega-3 percentages were 2.29% for vegans, 1.55% for vegetarians, and 1.46% for omnivores (p < 0.001). Docosahexaenoic acid percentages were not different by diet pattern, but over 80% of participants had milk concentrations below 0.30% of total fatty acids. Reports of omega-3 supplements use (10/74) and weekly seafood consumption (3/74) were limited. BDNF was not detectable in any samples. Conclusions: Breast milk from vegans had significantly higher unsaturated fat and total omega-3 fats, and lower saturated fats, trans fats, and omega-6 to omega-3 ratios than their vegetarian and omnivore counterparts. Docosahexaenoic acid concentrations in breast milk were low regardless of maternal diet pattern, and were reflective of low seafood intake and supplement use. [ABSTRACT FROM AUTHOR]

Background: The nutritional profile of human milk varies significantly between women, and the impact of maternal diet on these variations is not well understood. Objective: We analyzed breast-milk vitamin B-12 concentration and vitamin B-12 supplement use pattern among women who adhered to different dietary patterns: vegan, vegetarian, and nonvegetarian. Design: A total of 74 milk samples, 26 from vegan, 22 from vegetarian, and 26 from nonvegetarian breastfeeding mothers, were analyzed. Results: The prevalences of low vitamin B-12 (<310 pmol/L) were 19.2% for vegans, 18.2% for vegetarians, and 15.4% for nonvegetarians, which was not significant by diet group (P = 1.00). The median (quartile 1, quartile 3) vitamin B-12 values were 558 pmol/L (331, 759 pmol/L) for vegans, 509 pmol/L (368, 765 pmol/L) for vegetarians, and 444 pmol/L (355, 777 pmol/L) for nonvegetarians (P = 0.890). The use of individual vitamin B-12 supplements was higher in vegans (46.2%) than in vegetarians (27.3%) and nonvegetarians (3.9%) (P = 0.001). In linear regression analysis, the use of individual vitamin B-12 supplements was a significant positive predictor of milk vitamin B-12 concentration (β ±SE: 172.9±75.2; standardized β =0.263; P=0.024; R2 =0.069), the use of a multivitamin had a significant negative relation with milk vitamin B-12 concentrations (β ± SE −222.0 ± 98.7; standardized β = −0.258; P = 0.028, R² = 0.067;), whereas the use of a Bcomplex vitamin and prenatal vitamin were not predictive of vitamin B-12 milk concentration (P > 0.05). Conclusions: Almost 20% of our study participants were classified as having low breast-milk vitamin B-12 concentrations (<310 pmol/L), independent of maternal diet pattern. Approximately 85% of participants categorized as having low vitamin B-12 were taking vitamin B-12 supplements at doses in excess of the Recommended Dietary Allowance, which suggests that more research is needed to determine breast-milk adequacy values. [ABSTRACT FROM AUTHOR]

Third-party reproduction is a growing field, and an increasing body of literature considers the ethics of embryo donation. Due to the psychosocial complexities that generally accompany the donation and/or use of donor embryos, psychologists can play a pivotal role in these specialised fertility cases. While laws in the USA are in place to regulate the medical procedures involved in embryo donation, only unenforceable guidelines exist for psychologists specialising in fertility cases. The presentation of this case study aims to: (1) clarify the ethical concerns that fertility psychologists should consider in similar situations by assessing whether American Society of Reproductive Medicine (ASRM) and the American Psychological Association (APA) guidelines compete or complement one another within this case of embryo donation and (2) consider the interests, obligations and rights of all parties involved. Several principles, standards and guidelines that must be considered are described. Overall, the APA Ethics Code and the ASRM Guidelines appear to complement one another for most aspects of this case. Fertility psychologists should consider the clinical implications of the interests, rights and duties of all involved parties, including themselves. [ABSTRACT FROM AUTHOR]

The article offers information on the first-party claims for property damage which include coverage related to the damage caused by defective and corrosive dry wall in China and the U.S. It mentions that the drywalls that were manufactured in China emits sulfur gases including hydrogen sulfide. It offers information on several health problems related to corrosive drywall including, eye and skin irritation, breathing problems, and asthma attacks. It mentions that the policy exclusions for pollutants and contaminants, corrosion, and defective construction or materials preclude coverage for the losses.

This article investigates the development of transatlantic cooperation on homeland security. It analyses the extent to which existing forms of cooperation between states were suitable to deal with new security challenges as exemplified by the 11 September 2001 terrorist attacks and investigates what solutions were elaborated to address potential handicaps. It demonstrates how existing legal and political instruments limited the effective international cooperation in the field of homeland security (i.e. flexibility, adjustability and speed of action). This led to adjustments and emergence of new modes of governance in three realms: policy; polity; and politics. Three policy areas inform the conclusions reached in this article: data protection; container security; and mutual legal assistance. [ABSTRACT FROM AUTHOR]

This article explores the development of the EU border security policies through the prism of the EU-US homeland security cooperation in the aftermath of the September 11 terrorist attacks. As the case of the EU-US homeland security illustrates, international developments provide the context for the European policies to take shape. The case of the Passenger Name Record negotiations elucidates the evolution of the transatlantic networks universe - from the one based on geographical and political criteria (i.e. EU versus US, European institutions versus US institutions) towards functionally based networks (i.e. 'transatlantic diplomats' versus 'transatlantic security specialists', 'transatlantic executives' versus 'transatlantic legislatives'). It also shows that this shift takes place within a highly political process whereby actions and decisions evolve around network membership, centrality of actors and a particular role of bureaucrats. Finally, this article shows how the European approach to the use of personal data for security purposes emerges from interactions between the geographical and functional networks and allegiances that membership in those networks imply. This allows for certain ambivalence and ambiguity in the interpretation of actors' position. The article demonstrates that the European security debate is developing beyond the control of any single actor. [ABSTRACT FROM AUTHOR]

Background: Cocaine addiction is characterized as a chronically relapsing disorder. It is believed that cues present during self-administration become learned and increase the probability that relapse will occur when they are confronted during abstinence. However, the way in which relapse-inducing cues are interpreted by the user has remained elusive. Recent theories of addiction posit that relapse-inducing cues cause relapse habitually or automatically, bypassing processing information related to the consequences of relapse. Alternatively, other theories hypothesize that relapse-inducing cues produce an expectation of the drug's consequences, designated as goal-directed relapse. Discrete discriminative stimuli signaling the availability of cocaine produce robust cue-induced responding after thirty days of abstinence. However, it is not known whether cue-induced responding is a goal-directed action or habit. Methodology/Principal Findings: We tested whether cue-induced responding is a goal-directed action or habit by explicitly pairing or unpairing cocaine with LiCl-induced sickness (n = 7/group), thereby decreasing or not altering the value of cocaine, respectively. Following thirty days of abstinence, no difference in responding between groups was found when animals were reintroduced to the self-administration environment alone, indicating habitual behavior. However, upon discriminative stimulus presentations, cocaine-sickness paired animals exhibited decreased cue-induced responding relative to unpaired controls, indicating goal-directed behavior. In spite of the difference between groups revealed during abstinent testing, no differences were found between groups when animals were under the influence of cocaine. Conclusions/Significance: Unexpectedly, both habitual and goal-directed responding occurred during abstinent testing. Furthermore, habitual or goal-directed responding may have been induced by cues that differed in their correlation with the cocaine infusion. Non-discriminative stimulus cues were weak correlates of the infusion, which failed to evoke a representation of the value of cocaine and led to habitual behavior. However, the discriminative stimulus-nearly perfectly correlated with the infusion-likely evoked a representation of the value of the infusion and led to goal-directed behavior. These data indicate that abstinent cue-induced responding is multifaceted, dynamically engendering habitual or goal-directed behavior. Moreover, since goal-directed behavior terminated habitual behavior during testing, therapeutic approaches aimed at reducing the perceived value of cocaine in addicted individuals may reduce the capacity of cues to induce relapse. [ABSTRACT FROM AUTHOR]

All age, sex, and racial groups are affected by the obesity epidemic in the United States, although disparities exist among these groups. The Seventh-day Adventists are a religious group of people who are believed to live longer and healthier lives than do their non-Adventist counterparts because they do not smoke or drink alcohol and they eat a healthier diet. This study assessed the prevalence of overweight and obesity among Seventh-day Adventist college students attending 2 private universities in the southern United States. Most students' body mass index (65.8%) was within the normal weight category, 3.7% were underweight, 20.6% were overweight, and 9.9% were obese. Body mass index ⩾25 kg/ m² was more prevalent among men and African Americans. In all ethnic subgroups, the prevalence of overweight and obesity was lower than that among non-Adventist students reported in other studies. [ABSTRACT FROM AUTHOR]

Substitution of hospital staff performing concurrent utilization review (CUR) was evaluated using a production process framework. There were no differences in the number of reimbursement denials or denied days among 4 job classifications of hospital staff performing CUR, indicating that educational preparation of staff did not affect outcomes. The implications are that hospitals could substitute assistive staff in place of registered nurses to complete the CUR function, potentially increasing the availability of professional nurses. [ABSTRACT FROM AUTHOR]

The article focuses on the role of health literacy in the U.S. Health literacy is increasingly important to help people navigate complex health systems and better manage their own health. Health literacy is defined as the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions. Differences in the ability to obtain, process and understand materials related to health services appear to contribute to health disparities. Strategies and incentives for population health improvement affected by health literacy are recommended.

This study examines detention practices of sixty-six county juvenile courts in one state during a three year period. Two kinds of analyses are reported. First, courts with and courts without a detention home are compared. Second, in courts with a detention home the effect of the juvenile's prior court contacts, offenses, sex, and race on detention are examined. Courts without a detention home detain juveniles with less frequency than courts with a detention home even though juveniles in both types of courts have the same characteristics. Variation among the courts in detention practices as a consequence of the availability of a detention home suggests that there may be needless detention of children. The number of prior court contacts of a juvenile increases the probability of detention. Overall, offenders who commit juvenile code violations are more frequently detained than juveniles who commit other offenses. White females are detained more frequently than any other group. While some findings point to discriminatory handling of nonwhite juveniles, other findings suggest that nonwhites are not always treated more harshly than whites. The study of the careers of juveniles as they are processed through the court enables us to evaluate social control agencies and to make them responsive to the people they serve. [ABSTRACT FROM AUTHOR]

Examines the antimicrobial activity of BMS 284756, a novel des-fluoro quinolone and fluoroquinolones against Streptococcus pneumoniae in the United States. Susceptibility of S. pneumoniae on fluoroquinolones; Effectiveness of antimicrobial agents on the treatment of respiratory tract infections; Advantages of anti-infective agents.

Despite advances in the treatment of heart failure (HF), the rate of hospitalisation for exacerbations of the disease remains high. One of the underlying reasons is that recommended guidelines for the management of HF are still too rarely followed in daily practice. Disease exacerbation requiring inpatient treatment is always afactor that worsens the prognosis, and thus signals disease progression. This is also akey moment when therapy should be modified for HF exacerbation, or initiated in the case of newly diagnosed disease. Inpatient treatment and the peri‑discharge period is the time when the aetiology and mechanism of HF decompensation should be established. Therapy should be individualised based on aetiology, HF phenotype, and comorbidities; it should take into account the possibilities of modern treatment. According to the recommendations of the European Society of Cardiology (ESC), patients with HF should receive multidisciplinary management. Cooperation between the various members of the multidisciplinary team taking care of patients with HF improves the efficiency and quality of treatment. This document expands and details the information on the peri‑discharge management of HF contained in the 2021 ESC guidelines and the 2022 American Heart Association (AHA)/American College of Cardiology (ACC)/Heart Failure Society of America (HFSA) guidelines.